Computerized medical diagnostic and treatment advice system and method including mental status examination

• US 6,725,209 B1
• Filed: 06/06/2000
• Issued: 04/20/2004
• Est. Priority Date: 12/29/1993
• Status: Expired due to Fees

• Current Assignee: Clinical Decision Support, LLC (Tivity Health, Inc.)
• Original Assignee: First Opinion Corporation (Tivity Health, Inc.)
• Inventors: Iliff, Edwin C.
• Primary Examiner(s): Davis, George B.
• Application Number:
  US09/588,881
• Time in Patent Office: 1,414 Days
• Field of Search: 706/45, 600/300
• US Class Current: 706/45
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/7465 Arrangements for interactive communication between patient and care services, e.g. by using a telephone network telemetry of measured physiological signal A61B5/0002
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A system and method for providing computerized, knowledge-based medical diagnostic and treatment advice. The medical advice is provided to the general public over a telephone network. Two new authoring languages, interactive voice response and speech recognition are used to enable expert and general practitioner knowledge to be encoded for access by the public. “Meta” functions for time-density analysis of a number of factors regarding the number of medical complaints per unit of time are an integral part of the system. A semantic discrepancy evaluator routine along with a mental status examination are used to detect the consciousness level of a user of the system. A re-enter feature monitors the user'"'"'s changing condition over time. A symptom severity analysis helps to respond to the changing conditions. System sensitivity factors may be changed at a global level or other levels to adjust the system advice as necessary.

Claims

1. An automated medical advice or diagnostic system configured to conduct a mental status examination, comprising:

a computer including a storage;

an input device connected to the computer;

an output device connected to the computer;

at least one medical diagnostic function executed by the computer; and

a mental status function executed by the computer and choosing the execution of the at least one diagnostic function based on live interactions with a patient via the input and output devices.

2. The system defined in claim 1, wherein the mental status function comprises:

a selector configured to select one of a plurality of prestored questions, wherein the output device is configured to provide a patient with the selected question, and the input device is configured to receive an answer to the selected question from the patient;

a comparator configured to compare the answer to a prestored expected answer; and

wherein the mental status function includes a mental status score which may be changed according to the result of the comparison and a predetermined threshold value used to evaluate the score, and wherein an action appropriate to the mental status of the patient is determined by the evaluation of the score.

3. The system defined in claim 2, wherein the threshold value is indicative of the patient'"'"'s ability to meaningfully respond to questions.

4. The system defined in claim 2, wherein the action comprises transferring execution to the at least one diagnostic function.

5. The system defined in claim 2, wherein the answer is provided during a telephone call and the action comprises writing patient information to a temporary file and transferring the patient on the telephone call to a medical staff person.

6. The system defined in claim 1, wherein the computer is a personal computer.

7. The system defined in claim 1, additionally comprising a telephone connected via a telephone network to the input device.

8. The system defined in claim 7, wherein the input device comprises a voice recognizer.

9. The system defined in claim 7, wherein the output device comprises a speech synthesizer.

10. An automated medical advice or diagnostic system for conducting a mental status examination, comprising:

a computing device including a storage;

an input device connected to the computing device;

an output device connected to the computing device;

medical diagnostic means, executed by the computing device, for diagnosing a medical condition of a patient; and

mental status means, executed by the computing device, for choosing the execution of the medical diagnostic means based on live interactions with the patient via the input and output devices.

11. The system defined in claim 10, wherein the mental status means comprises:

means for selecting one of a plurality of prestored questions, wherein the output device is configured to provide the patient with the selected question, and the input device is configured to receive an answer to the selected question from the patient;

means for comparing the answer to a prestored expected answer; and

wherein the mental status means includes a mental status score which may be changed according to the result of the comparing and a predetermined threshold value used to evaluate the score, and wherein an action appropriate to the mental status of the patient is determined by the evaluation of the score.

12. A method of conducting a mental status examination of a patient in an automated medical advice or diagnostic system having a computer with an input device and an output device, the method comprising:

executing a medical diagnostic function on the computer;

automatically performing a mental status function on the computer in conjunction with the executing of the medical diagnostic function, wherein the mental status function includes automated interactions with a patient via the input and output devices; and

choosing the execution of the medical diagnostic function based on the results of performing the mental status function.

13. The method defined in claim 12, wherein automatically performing the mental status function comprises:

a) selecting one of a plurality of prestored questions, wherein the output device is configured to provide the patient with the selected question, and the input device is configured to receive an answer to the selected question from the patient;

b) comparing the answer to a prestored expected answer;

c) updating a mental status score according to the result of the comparison;

d) evaluating the score against a predetermined threshold value; and

e) automatically determining an action appropriate to the mental status of the patient by the results of the evaluating.

14. The method defined in claim 13, wherein a)-c) are repeated for at least one additional prestored question prior to performing d).

15. The method defined in claim 13, wherein the threshold value is indicative of the patient'"'"'s ability to meaningfully respond to questions.

16. The method defined in claim 13, wherein the action comprises transferring execution to the medical diagnostic function.

17. The method defined in claim 13, wherein the answer is provided during a telephone call, and the action comprises writing patient information to a temporary file and transferring the patient on the telephone call to a medical staff person.

18. The method defined in claim 12, wherein the computer is a personal computer.

19. The method defined in claim 12, additionally comprising connecting a telephone to the input device via a telephone network.

20. The method defined in claim 12, wherein the output device comprises a speech synthesizer.

21. The method defined in claim 12, wherein the input device comprises a voice recognizer.